Provider Demographics
NPI:1477120616
Name:SONRISA ESPERANZA CAPITATION LLC
Entity Type:Organization
Organization Name:SONRISA ESPERANZA CAPITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:K
Authorized Official - Last Name:KORKUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-722-6460
Mailing Address - Street 1:3520 S MORGAN ST STE 207-208
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1533
Mailing Address - Country:US
Mailing Address - Phone:312-722-6460
Mailing Address - Fax:312-893-2275
Practice Address - Street 1:3059 W 26TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-4131
Practice Address - Country:US
Practice Address - Phone:773-247-7600
Practice Address - Fax:773-847-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty